Provider Demographics
NPI:1104944784
Name:INSTITUTE FOR INTEGRATIVE MEDICINE
Entity type:Organization
Organization Name:INSTITUTE FOR INTEGRATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NURSE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:502-797-1904
Mailing Address - Street 1:205 TOWNEPARK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2318
Mailing Address - Country:US
Mailing Address - Phone:502-253-4554
Mailing Address - Fax:877-273-4414
Practice Address - Street 1:205 TOWNEPARK CIR STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2318
Practice Address - Country:US
Practice Address - Phone:502-253-4554
Practice Address - Fax:877-273-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service